The midterm elections and Medicare for all

By Dr. Quentin YoungThe Huffington Post, October 15, 2010

As we approach Nov. 2, it's fair to say that in many ways the distortion of political discourse in our country has never been worse.

Extreme right-wing personalities - reincarnated Know-Nothings - are elbowing their way into the nightly airwaves via paid advertisements and Fox News. Billionaires are lavishly funding the Tea Party movement and an assortment of anti-government themes.

As our serious economic destabilization continues, and in the absence of vigorous progressive voices offering convincing, evidence-based solutions to our problems, our population is increasingly being abandoned to the clutches of ultra-right yahoos like Sharron Angle in Nevada, Pat Toomey in Pennsylvania, Ed Martin in Missouri and Christine O'Donnell in Delaware, to name just a few.

Pernicious ballot initiatives aiming to turn the clock back on health care and other social issues have been put on several state ballots, often the result of ultra-conservative stealth organizations deploying deliberately misleading language. Arizona's Proposition 106, which would proscribe a single-payer system (and prohibit various other federal health programs), is a case in point.

These developments are creating a perilous situation for the republic.

It must be said that the quality of political discourse in the run-up to the midterm elections has not been facilitated by the flawed health reform legislation that the administration squeaked through Congress this spring.

While there are some desirable parts of the Obama administration's new health law - the funding of community health centers, the expansion of Medicaid, the modest but not unimportant efforts to curb insurance company abuses - it is still widely viewed with unease by the public.

In fact, a recent AP/Stanford/Robert Wood Johnson Foundation poll showed twice as many Americans - 40 percent - believe that the law doesn't go far enough as believe the government should not have a role in health care, and four-fifths of the public favor "making sure that more Americans get the health care they need."

The recent spate of insurance company premium hikes and their pre-emptive dropping of whole classes of potentially unprofitable policies, such as those that cover individual children, by insurers like WellPoint, UnitedHealth Group, Aetna, Cigna and Humana, haven't helped build public confidence in the new law's ability to rein in these corporate profiteers.

Nor have reports that insurance companies and employers are successfully negotiating waivers to evade some of the modest requirements contained in the law.

As a result, skepticism in the law abounds. Polls suggest Republican calls to repeal or defund the new law have gotten some traction, even though their crude scare tactics - e.g. their charge that the administration's health law is "socialist" - are patently ridiculous.

Big insurers are giving large donations to the GOP again (after having given so generously to Democrats in the run-up to the new law), hoping to dictate the terms of the law's implementation in a way most favorable to their mercenary interests.

Meanwhile the health care situation in the U.S. is deteriorating at a more rapid pace. The Census Bureau data reported a few weeks ago indicated a startling 4.3 million increase in the number of uninsured since 2008, to 50.7 million people last year. This number would have been much larger if public insurance programs, in the first place Medicaid, hadn't enrolled an additional 6 million people. The new uninsured numbers represent enormous human suffering.

It's worth noting that the much vaunted public option, had it been incorporated into the new law, would have had a negligible affect on this number, according to a letter from the Congressional Budget Office. Besides inviting an insurer's field day of cherry picking, such a provision would have been anything but a step toward single payer, as some of its advocates claimed.

So what to do?

First, it's important to recognize there are a number of candidates running for office this November who support single-payer legislation, both incumbents and challengers. The candidacy of Dr. David Gill in Illinois' 15th congressional district is but one example. Building up a single-payer caucus in Congress is an important goal, as is the continuing enlistment of support for single-payer legislation like Rep. John Conyers' H.R. 676 and Sen. Bernie Sanders' S. 703.

Second, several state-based movements for single payer are pressing their agenda for local reform. These states include Vermont, where an important Legislature-funded study on state models for reform - including single payer - is well under way, where several candidates have been vying with each other as to who's more supportive of single payer, including gubernatorial candidate Peter Shumlin. Sen. Sanders has pledged to seek whatever federal waivers are needed should the people of his state declare their preference for a single-payer system.

Third, Medicare, Medicaid and Social Security are under a serious threat from the National Commission for Fiscal Responsibility and Reform. The commission is presumably going to make recommendations for changing these vital social insurance programs in its report to a lame-duck Congress by Dec. 1. Any cuts should be emphatically rejected. Medicare should be strengthened by improving it and expanding it to everyone. That's also one of the surest ways to control skyrocketing health costs, as a recent congressional briefing by PNHP leaders and others recently pointed out.

Finally, our educational work in support of an improved Medicare for all remains indispensable. There are good reasons to believe that the new health law will be subject to destabilizing pressures from several quarters, including from actions by incorrigible offenders like the insurance industry (which is already complaining about the law's minimal restraints), and the law may unravel sooner than many suspect. Single-payer Medicare for all needs to be ready to fill the gap when that happens, and a powerful people's movement needs to be ready to push it forward in a new, dramatic way.